Online ISSN: 2515-8260

Keywords : Breast Cancer


EVALUATION OF EFFICACY OF COMBINED ULTRASOUND GUIDED PECTORAL NERVE BLOCK TYPE 2 WITH ROPIVACAINE AND GENERAL ANAESTHESIA OVER PLAIN GENERAL ANAESTHESIA IN CANCER RELATED BREAST SURGERIES

Sama Madhavi, V Vijay Kumar Reddy, J R Praveen Kumar, Lakkam Vamsee Kiran, Saai Ram Thejas

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3799-3808

Breast cancer is the most common cancer among the woman and is on rise. Surgery is one of main stays of treatment of breast cancer. Pectoral nerve block type 2 is an extension of type 1 that requires additional injection of local anaesthetic between pectoralis minor and serratus anterior muscle.
MATERIALS AND METHODS
This Prospective Randomized Controlled study wad conducted between January and June 2020. 60 Patients undergoing Mastectomy under General Anaesthesia with an ASA of I or II were taken. In Group P, 0.4ml/kg of the drug is deposited above the serratus anterior muscle.
OBSERVATIONS AND RESULTS
The difference in baseline mean systolic and diastolic blood pressures of two groups was statistically not significant. Time of first rescue analgesia is significantly higher in group P (5.89±2.25 hours) than group C (2.08±0.7 hours). Pains scores are significantly higher in group C compared to group P at all times after surgery from 2 to 18 hours postoperatively. The patients who received block used significantly less morphine than the control population. None of the patients in group P experienced block related complications.
DISCUSSION
The perioperative anaesthetic care for those undergoing mastectomy surgery is general anaesthesia with a multimodal approach for analgesics such as opioids, paracetamol and NSAIDs. In our study postoperative Pains scores are significantly higher in group C compared to group P at all times after surgery, similar to other studies.
CONCLUSION
Our study will certainly support the fast-evolving thinking in the field of perioperative medicine, regional anaesthesia and pain management. The results of our study is supportive, in proving, the two-level PECS block is safe, effective, reliable, easy to perform, decreases morphine consumption, improves postoperative pain, provides patient satisfaction, in breast cancer related surgery, thereby, achieving the primary outcome

ANTI METASTATIC EFFECT OF PERGULARIA DAEMIA ON BREAST (MCF-7) CANCER CELL LINE

Aditya Mantri, Gayatri Devi.R, J.Selvaraj .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2601-2608

Background: Breast cancer develops as a result of genetic mutations or damage to DNA. On average only 35% women with advanced breast cancer are alive five year after diagnosis. However, search for new anticancer drugs for effective treatment is on as the plant- based system of medicine does not pose serious problems. So, the aim of this study is to analyze the antimetastatic effect of Pergularia daemia on Breast (MCF-7) cancer cell lines
Materials and Methods: P.daemia was collected, powdered and Soxhlet extracted with 70% ethanol. It was then filtered and solvent evaporated to get a viscous mass, which was then stored at 4C until used.
Results: By optimizing the concentration of treated P.daemia it significantly decreases cell viability. Bcl-2 and Bcl-xL show significant decrease in expression with higher concentration of P.daemia treated cells. A significant increase in the Caspase-3 mRNA activity was observed after incubation with the leaf extract of P.daemia.
Conclusion: Pergularia daemia exhibits antimetastatic effect on breast (MCF-7) cancer cell lines. The active component of P.daemia may promote the antimetastatic effect on breast cancer cell lines.

Effectiveness of Cognitive-Behavioral Group Therapy on Depression, Anxiety, and Pain Coping Strategies in Women with Breast Cancer

Dr. Pantea Nabian

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1995-2005

Objective: The present study aimed to investigate The Efficacy of Cognitive-Behavioral Group Therapy on depression, anxiety, and Pain Coping Strategies in women with breast cancer.
Methods: The present study is a semi-experimental research wth a pretest-posttest With the control group. For this purpose, 50 people Of women with breast cancer were admitted to the Medical university hospitals of Tehran method Purposive sampling was Selected Randomly in two experimental and control groups were replaced. The experimental group underwent group therapy for 10 sessions of 1.5 hours per week after fully explaining the research and expressing their consent on how to do the work. Demographic statistics, descriptive statistics (mean and standard deviation), and inferential statistics (analysis of covariance (ANCOVA)) were used to perform statistical calculations and data analysis (SPSS 25).
Results: The results showed that Cognitive-behavioral group therapy significantly reduces depression and anxiety in women with breast cancer. Also in the use field of Pain Coping Strategies Between the experimental and control groups, there is a significant difference. 
Conclusion: The results showed that Cognitive-Behavioral Group Therapy reduces depression and anxiety and increases the use of Pain Coping Strategies in women with breast cancer. 

In Silico Analysis To Identify The Inhibitory Potential Of Endogenous Superoxide Dismutase On Apoptotic Markers Relevant To Breast Cancer.

Gopika. G.G; Lavanya Prathap; Selvaraj Jayaraman; Preetha. S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 638-648

Breast cancer arises when certain breast cells start to grow abnormally they  divide and replicate at a greater rate than normal cells. Regular exercise helps to reduce breast cancer by 10 to 20 percent. AIM: To analyse the inhibitory potential of endogenous over expression of superoxide dismutase (SOD) on apoptotic markers in breast cancer through silico analysis.
    The molecular docking analysis is a bioinformatic study. The endogenous substance SOD which is secreted after exercise is used as a target protein. The interaction of SOD with proteins relevant to breast cancer namely Bcl-2, Bcl-xl, Bax are included for docking analysis. The protein structure is retrieved using protein data bank, protein protein docking done using patch dock server followed by visualisation of protein -protein interaction using pymol.

Fluctuating Asymmetry of Hand Dermatoglyphics in Female Breast Cancer Population

Lavanya Prathap; Prathap Suganthirababu; Kumaresan A; Vignesh Srinivasan; Aravind Ganesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 500-507

Background: Breast cancer being a common cancer in women among reproductive age, effective screening criteria should be in practice to keep apart the high risk population for breast cancer and thereby prevention of the disease..  The present study identifies the FA of digital and palmar dermatoglyphic variables specific for breast cancer, which can be utilized to set apart the population at risk, take preventive and early therapeutic measures. Methods: The participants are grouped in to 50 each based on selection criteria. Data collected in the form of digital photographic images of the digits and palm of the right and left hand and the variables are analyzed visually with assistance of computer. The Student t’ test is applied to examine the quantitative variables and to measure the FA between dermal ridges of the right and left hand. Results and Conclusion: The typical dermatoglyphic variables that can be utilized to insulate the high risk population includes FA Thumb, FA Ring finger and FA A-B ridge count. The overall observation of the results obtained from the study demonstrated a substantial divergence in the fluctuating asymmetry of dermal ridge patterns of healthy participants from the high risk and breast cancer group and the patterns followed in high risk and breast cancer group helps to categorize to some extent the familial origin of chest malignant neoplastic disease.

USE OF METHYLENE BLUE DYE TECHNIQUE IN BREAST CANCER SENTINEL NODE BIOPSY – A NOVEL UPDATE

Dr. Pankaj Kshirsagar, Dr. Samir Gupta, Dr. Tejus V Nagireddy, Dr. Advait A Vaidya .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1785-1792

Background: Axillary lymph node dissection (ALND) has been the standard treatment of breast cancer axillary staging in India. The limited facilities of radioisotope tracer and isosulfan or patent blue dye (PBD) have been the major obstacles to perform sentinel node biopsy (SNB) in our country. Hence, we studied the application of 1% methylene blue dye (MBD) alone for SNB to overcome the problem. The study's main goal is to assess the identification rates and negative predictive value (NPV) of SNs in predicting axillary metastases using only 1 percent MBD.
Methods: This prospective study enrolled 108 patients with suspicious malignant lesions or breast cancer stages I–III. SNB was performed using 2–5 cc of 1% MBD and proceeded with ALND. The histopathology results of sentinel nodes (SNs) were compared with axillary lymph nodes (ALNs) for diagnostic value assessments.
Results: There were 96 patients with invasive carcinoma from July 2020 to September 2021 at Dr.D.Y.Patil Hospital and Research Centre , Pimpri , Pune who were included in the final analysis. The median age was 50 (25–69) years, and the median pathological tumor size was 3 cm (1–10). Identification rate of SNs was 91.7%, and the median number of the identified SNs was 2 (1–8). Sentinel node metastasis was found in 53.4% cases and 89.4% of them were macrometastases. The negative predictive value (NPV) of SNs to predict axillary metastasis was 90% (95% CI, 81–99%). There were no anaphylactic reactions, but we found 2 cases with skin necrosis.
Conclusions: The application of 1% MBD as a single technique in breast cancer SNB has favorable identification rates and predictive values. It can be used for axillary staging, but nevertheless the technique should be applied with attention to the tumor size and grade to avoid false negative results.

Assessment of d-dimer levels among breast carcinoma patients

Dr. Deepak Kumar Yadav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9799-9802

Background: To assess d-dimer levels among breast carcinoma patients
Materials & methods: A total of 100 breast carcinoma patients were enrolled. Complete demographic details of all the patients were obtained. Only those patients were included in which histopathologic confirmed diagnosis of breast carcinoma was present. A Performa was made and detailed clinical and medical history of all the patients was recorded. Blood samples were obtained from all the patients and serum D Dimer levels were evaluated using auto-analyser
Results: Mean D Dimer levels were found to be 2.74 μg/mL. Mean D-Dimer levels among patients with and without lymph node involvement was 2.981 μg/mL and 1.512 μg/mL respectively. Significant results were obtained while comparing the mean D-Dimer levels among patients with and without lymph node involvement.
Conclusion: D-Dimer levels are significant altered in breast cancer patients with lymph node involvement.

Micro Rna 22 (Mirna22) And Breast Cancer:A Review

Usha Adiga, Desy TM

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9045-9053

WHO has reported that, 2.3 million women were diagnosed with breast cancer in 2021 and 685000 deaths occur globally due to breast cancer. As estimated at the end of 2020, there were 7.8 million women diagnosed with breast cancer in the past 5 years were alive, making it the world’s most prevalent cancer. Breast cancer is the most common cancer type in Indian female, and many patients suffer from recurrences and metastasis. There is no marker to predict the severity and invasiveness of breast cancer. Single-stranded, non-coding RNA molecules called microRNAs (miRNAs) control the expression of target genes through post-transcriptional alterations . Numerous studies suggested that miRNA has a promising role in the diagnosis and prognosis of various malignancies. In a number of malignancies, including gastric cancer, esophageal squamous cell carcinoma, breast cancer, and prostatic cancer, miR-22 is aberrantly expressed either up or down. miRNA-22 may be used a diagnostic as well as prognostic marker for breast cancer.
 

Smarca4 Gene Polymorphism And The Breast Cancer: A Review

Usha Adiga, Desy TM

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9029-9036

Cancer is simply due to the mutations at the genetic level, commonly known as genetic disorder. In this condition the cells suffer from uncontrolled growth of cell division. These mutations can be acquired or may occur in somatic cells. Somatic cell mutations cannot be inherited while germ line mutations are inherited. In general, cancer cells have more genetic changes than normal cells. But each person’s cancer has a unique combination of genetic alterations. Some of these changes may be the result of cancer, rather than the cause. As the cancer continues to grow, additional changes will occur. Even within the same tumor, cancer cells may have different genetic changes.
The genes that contribute to cancer development are tumor suppressor genes, Oncogenes and DNA repair genes. Tumor suppressor genes are protective genes and they limit cell growth by monitoring how quickly cells divide into new cells, repairing mismatched DNA and controlling when a cell dies. These include BRCA1, BRCA2, and p53 or TP53. When a tumor suppressor gene mutates, cells grow uncontrollably. And they may eventually form a tumor. Oncogenes turn a healthy cell into a cancerous cell. Mutations in these genes are not known to be inherited. Common oncogenes are HER2 and the RAS family of genes.The role of SMARCA4 gene has been least explored in breast cancer.

DETAILED STUDY OF PARAVERTEBRAL BLOCK ANAESTHETIC MANAGEMENT IN PATIENTS WITH CARCINOMA BREAST FOR MODIFIED RADICAL MASTECTOMY

DR.M.MADHAN KUMAR, DR. CHERAN, DR. KAMALUDEEN

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 6174-6181

To assess safety and efficacy of the regional anesthetic technique paravertebral block for operative treatment of breast cancer, and to compare postoperative pain, nausea, vomiting, and length of hospital stay in patients undergoing breast surgery using paravertebral block and general anesthesia. General anesthesia is currently the standard technique used for surgical treatment of breast cancer. Increasing hospital costs have focused attention on reducing the length of hospital stay for these patients. However, the side effects and complications of general anesthesia preclude ambulatory surgery for most patients undergoing breast surgery.Paravertebral block can be used to perform major operations for breast cancer with minimal complications and a low rate of conversion to general anesthesia. Paravertebral block markedly improves the quality of recovery after breast cancer surgery and provides the patient with the option of ambulatory discharge

Breast Cancer Nodal Staging- Reliability of Clinical Assessment with Core Biopsy

Arpan Mishra; Hari Damde; Yogesh Tiwari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 1903-1907

Background: Aim of this study to estimate the diagnostic accuracy of clinical assessment with ultrasound guided axillary node core needle biopsy (CNB) / fine needle aspiration cytology (FNAC) for axillary staging in early stage breast cancer. Materials and Methods: This prospective study was conducted in a tertiary care centre of central India in medical college hospital Jabalpur. We identified 64 consecutive patients of newly diagnosed early stage breast cancer. After clinical examination, ultrasound axilla guided core biopsy or fine needle aspiration cytology was performed if the node was in ultrasound. Axillary node dissection was performed in all patients. Preoperative and postoperative nodal positivity was compared and analysed. Results: Clinically and by ultrasound sensitivity and specificity of metastatic nodes was 50 and 75% and 75 and 83% respectively. False negative rate of our study was 6.2% that is equivalent to sentinel node biopsy. Sensitivity of guided FNAC/biopsy was 50 % in our study. Conclusion: Our study showed use of detailed clinical assessment is a good alternative where facility of sentinel node biopsy is not available. It is a good and less morbid alternative to sentinel node biopsy and if the result is positive can proceed directly to axillary node dissection

An Epidemiological, pathological & Clinical assessment of Breast Carcinoma patients attending local secondary and tertiary care hospitals

Dr. Dhananjay Prasad , Dr. Vinay Tiwari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4994-5007

Introduction : Breast cancer is by far one of the most frequent cancer in female, both in developed and developing regions. Early diagnosis and treatment will reduce the morbidity and mortality of the disease and thus it prolongs the survival of the patient. Aim of the  study is to assess  the various type of clinical and pathological patterns of presentation of operable carcinoma breast cases in local region.
Methods: This was a  Retrospective analytical  study of 200 cases of Breast Carcinoma. Relevant clinical features like age, parity ,  laterality of the tumor, mode of presentation, history of breast cancer in 1st degree relative, fixity of the tumor and skin, and nipple-areola changes were assessed. Size, number, and location of tumor in mastectomy specimens were noted macroscopically. Microscopically, histological type, histological grade  lymphatic and blood vessel invasion, and lymph node involvement were evaluated.
Results: Most of the patient belongs to 41-50 years age group. 61% were  presented with left-sided breast Cancer. 52% presented with UOQ lump, 57%  presented with 2-5cms2 sized tumor. Maximum patients complain of Lump and Pain .Around 91% of the patients Histopathological report  showed Invasive Ductal Carcinoma. Mostly were  histological grade 3 tumors with Lympho-vascular invasion  was identified in 28%. Lymph nodes were involved in  54% cases. 41% of the patient were of  stage II B, followed by 22% with stage II A.
Conclusion: Invasive ductal carcinoma (IDC), not otherwise specified (NOS), is the most common histologic type. Its frequency of occurrence far exceeds that of the other histological types. Most commonly affected age group by breast cancer is 41-50 years, and most of the patients are from post-menopausal age group. Size of the mass was more than 2 cm involving multiple quadrants of breast and with positive lymph nodes. Histologically, grade 3 tumor is most prevalent in study population. Stage II A & II B Comprise maximum patients . 

Quality of life in breast cancer patients suffering from Psychiatric disorders before and after diagnosis

Dr. Anil Gorakshanath Korade

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 492-495

Background: The present study was undertaken for assessing the quality of life in patients with breast cancer before and after diagnosis.
Materials & methods: 200 patients were enrolled for the present study. A complete demographic and clinical detail of all the patients was obtained. At the baseline stage, interview was conducted among all the patients after obtaining their prior consent. This interview was conducted with the aim of gathering data in relation to quality of life. Afterwards, 100 patients that had confirmed histopathological diagnosis of breast cancer were separated and remaining all the patients was excluded. Follow-up of all the patients was done and re-interview of all the patients was again carried out. All the results were recorded and analysed using SPSS software.
Results: At the baseline period, initial treatment was mastectomy in 81 percent of the cases followed by conservative surgery in 9 percent of the patients. Quality of life score showed abrupt phases at different follow-up. Overall, global quality of life score showed improvement from score of 63.3 to 75.8 at 6 months follow-up followed by a significant decline to a value of 39.8.
Conclusion: Breast cancer patients should be followed up for their quality of life and provided effective therapy for their physical and psychological problems.

Breast cancer in elderly women: Clinical profile and management

Dr. Shantkumari B, Dr. Maktum Naik, Dr. Jairaj Bhaskar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2065-2069

Clinical examination should be systematic and take account of the nature of the lump and, if present, any skin dimpling or change in contour of the breast and also assessment of the axilla for presence of axillary nodes. Breast abnormalities should be evaluated by triple assessment including clinical examination, imaging (mammography and ultrasound) and tissue sampling done either fine needle aspiration cytology or core biopsy. This study was conducted on all the clinically diagnosed cases of breast cancer in elderly women aged above 60, who will undergo treatment based on clinicopathological diagnosis of breast cancer. Data collected after obtaining written informed consent. Among 50 patients, 23(46%) patients took adjuvant chemotherapy. 5(10%) patients took both adjuvant chemotherapy and radiotherapy. 4(8%) patients took only radiotherapy. 17(14%) patients did not take any adjuvant therapy.

Pattern of breast cancer among low socioeconomic status patients attending tertiary care center in North India-A tenyear data analysis

Ramandeep Singh, Rajiv Devgan, H D Jyoti. .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 100-110

Background- Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death.
Objective- To study the pattern of breast cancer among low socioeconomic status patients attending a tertiary care hospital (Government medical college, Amritsar).
Materials and methods- A retrospective study was conducted in the department in which data was analysed in terms of demographical profile, stage of presentation, risk factors, histologic type and management strategies.
Results- A total of 1706 patients were studied in the study in ten year period. These were mostly poor and of low socioeconomic status who completed the treatment under Chief Minister Cancer Relief Fund (CMCRF) scheme. The mean age at diagnosis was 50.57+/-10years. Majority of patients were in age group 50-59 years (551 with 32.29%) and 40-49years (531 with 31.12%). Left sided breast carcinoma patients were more in number 913(53.51%) versus right sided as 791(46.36%). 936(54.86%) patients were from urban and 770(45.13%) patients were from rural areas. Male breast cancer patients were 17(1%), among females maximum number i.e.857 (50.23%) presented as postmenopausal followed by 511(29.95%) as perimenopausal followed by 321(18.81%) as premenopausal women. Infiltrating ductal carcinoma is the most common histopathology with 90.62%. Luminal type A comprises 45.72% subtype then 36.10% with Basal subtype followed by 11.43% with Her2neu enriched and 6.74% with Luminal type B subtype. There were 256(15%) patients in whom recurrence or progression of disease occurred.
Conclusion- In this study, breast cancer trend is rising with time and more patients presented in late and advanced stages mostly due to lack of awareness, so we conclude that public health education for early detection of breast carcinoma is necessary and at the same time government schemes like CMCRF helps in bringing more and more patients for free treatment to the government hospitals and thus giving them a chance for good survival.
 

Factors Affecting Seroma Formation after Modified Radical Mastectomy in Patients of Carcinoma Breast: A Prospective Study

Rohit Kumar Soni, Milan Kumar Khatri, Meenakshi Suhalka, Rakesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10507-10513

Introduction: Seroma formation is the most common complication after breast cancer
surgery, especially when axillary dissection is performed.
Aim: This study intends to find out the association between certain pre-operative, intraoperative,
and post-operative factors related to MRM and incidence of seroma
formation.
Methods: A total of 50 patients with Ca breast undergoing breast surgery were
admitted in surgical wards at tertiary carehospital.
Results: The cumulative total seroma volume collected by the end of treatment was
higher and the overall time of seroma treatment was longer in patients over the age of
60 years (60.89±9.17 vs 55.25±10.05years p<0.001) and more obese (BMI, 26.78±5.2
versus 24.86±3.91; p<0.001). Higher amount of initialdrain volume was directly related
to seroma formation.The incidence is decreased byearly initiation of arm physiotherapy
after surgery (3.21±0.91 days versus 2.08±0.76 days; p=0.0001).
Conclusion: The incidence of seroma is higher in older, obese patients and higher drain
output. The incidence is decreased by early physiotherapy. Interventions in the
operative period reduce the seroma formation.

“A STUDY ON EXPRESSION OF ESTROGEN AND PROGESTERONE RECEPTORS IN BREAST CARCINOMA: A TERTIARY CARE HOSPITAL EXPERIENCE”

Dr. REBECCA MATHEWS, Dr. BINDU KUMARI, Dr. T SPANDANA

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2856-2871

Background:Breast cancer is common cancer in women in both the developed and the less
developed nations. Since the 2008 estimates, breast cancer incidence has increased by more than
20%, while mortality has increased by 14%. Breast cancer is now the most common cancer in
most cities in India, and second most common in the rural areas.AIM:To evaluate the percentage
of breast carcinomas expressing estrogen receptors and progesterone receptors and to correlate the
ER & PR status with other prognostic parameters like histological type, grade, tumour size, and
lymph node metastasis.Material & Methods: Study Design: Hospital based Prospective
observational study.Study area: Dept. of. Pathology, in a tertiary care teaching college and
hospital. Study Period: 1 year.Study population: patients who were resected for surgical breast
specimens by modified radical mastectomy, lumpectomy or specimens and sent for pathological
analysis. Sample size: study consisted a total of 100 patients. Sampling method: Simple
Random sampling method.Inclusion Criteria: Carcinomatous lesions of breast. Ethical
consideration: Institutional Ethical committee permission was taken prior to the commencement
of the study.Study tools and Data collection procedure: The specimens were thoroughly
grossed according to the standard protocol and those which fulfilled the inclusion criteria were
evaluated for following data (1) tumour size (2) infiltration of the tumour to nipple and areola (3)
infiltration onto posterior margin (4) necrosis (5) desmoplasia (6) calcifications and (7) number
of lymph nodes involved.Statistical Analysis:The data was collected, compiled and compared
statistically by frequency distribution and percentage proportion. Quantitative data variables
were expressed by using Descriptive statistics (Mean ± SD). Qualitative data variables were
expressed by using frequency and Percentage (%).Student t test (two tailed, independent) has
been used to find the significance of study parameters on continuous scale between two groups
Inter group analysis) on metric parameters. Chi-square test has been used.

Significance of Red Cell Distribution Width to Platelet Count Ratio (RPR) in Patients with Breast Cancer

Pravallika Mallipeddi, Sowjanya Rakam, Venkata Sri Laxmi Chennupati

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1955-1960

Background: Red cell distribution width (RDW) to platelet ratio (RPR) is a
prognosticator in acute pancreatitis and myocardial infarction; however, the prognostic
values of RDW and RPR in breast cancer have not been studied. This retrospective
analysis of 50 breast cancer patients investigated the association between RDW and
RPR and clinicopathological characteristics and prognosis, compared to platelet
distribution width to platelet count ratio (PDW/P) which is a known independent
prognostic factor in patients with breast cancer. Aims and Objective: Our study aimed
to know significance of elevated RPR in breast cancer, to correlate the RPR with the
clinicopathological characteristics of breast cancer (tumor grade, lymphatic spread,
over expression of hormonal receptors and HER2 protein).
Materials &Methods:It was a Retrospective study. Patients with histologically
confirmed breast cancer were included in study. Patients with heart failure / On
dialysis/ Lacking the entire set of clinicopathological data were excluded in this study.
Results: RPR was higher in patients with breast cancer. RPR elevation was significantly
correlated with high grade tumors, number of infiltrated lymph nodes and HER2 over
expression.
Conclusion: Our study indicates that elevated preoperative RDW levels are indicative of
tumor spread and progression of breast cancer. RPR is a cost-effective and novel
biomarker which can help in assessing the microscopic grading of Breast cancer.

STUDY OF BREAST CANCERS IN A TERTIARY CARE CENTRE IN SOUTH INDIA

M. Vijayasree, Himaja Sayana, SKSalma, Anjali CV, Jeeva MJ

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11594-11603

Background:Cancer is one of the major health issues worldwide. In the year 2020, the Global burden of cancer rose to an estimated 19.29 million new cases and 9.95 million deaths. In India, according to year 2020 Statistics, Breast Cancer was the most prevalent cancer in women, followed by cancer of Cervix Uteri. During the past two decades, the incidence of Breast cancer has increased tremendously.  The cause may be attributed to “Westernization” trends.
Materials and Methods: The present study is a retrospective study where all modified radical mastectomy specimens received in the department were grossed and processed and sections stained with Haematoxylin and Eosin.  A total of 24 modified radical mastectomy specimens were evaluated.
Results: Most of the cases(41.66%) belonged to age group of 61-70 yrs, with 13 cases (54.16%)had tumour size more than 5cms. Invasive Carcinoma –NST was the most common Malignancy detected. Most of the cases were in stage –III of Breast Malignancy.
Conclusion: Early detection and timely treatment is essential to prevent further spread of Malignancy. Screening programmes should be intensified to increase awareness among women about Breast Cancer.

The Effect Of Breastfeeding In Premenopausal Breast Cancer : A Review

Ohood Mahmood Algaralleh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10102-10106

In this review, I describe the effect of breastfeeding in premenopausal breast cancer in Jordan. For the time being, breast cancer is considered to be the most frequent type of cancer among women in the world. Many studies explore the effect of breastfeeding to prevent of  breast cancer, although studies have suggested that breastfeeding reduces the risk of breast cancer. In 2020, 2.3 million women diagnosed with breast cancer and 685 000 deaths in breast cancer in the world. In the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer (WHO, 2021). mothers should be encouraged to breastfeed their babies because the clinical evidence has shown that there is a lower risk of breast cancer in women who breastfed their babies.

A Single Axillary Crease Incision for Wide Local Excision and Axillary Clearance in Early Breast Cancer

Mansour Mohammed Morsy, Ahmed Raafat Abdelfattah, Joseph Rizk Israel, Ahmed Atef A. Zordok .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 895-902

Background: Breast cancer is the commonest malignancy in females. Despite the several surgical techniques that have been used to provide the ultimate pathological clearance and cosmetic results, the aesthetic outcome and scarring are not appreciated. Therefore, this current thesis is conducted to study a new technique to reduce this scarring. The single axillary crease approach is not currently used in Zagazig University Hospitals.
Patients and methods: An interventional Study included 30 cases with breast cancer who admitted to Zagazig University Hospitals. All patients were informed regarding this type of breast conservative surgery and the post-operative demands of the follow up.
Results: Patient age range was 35-52and that the mean age was 43.53. The tumor size range was (0.8-4.9) and the mean tumor size was 3.24. The number of cleared lymph nodes ranged from (5-29). About 73.3% of the cleared lymph nodes tested postive by histopathological examination. About 6.7% of the cases were complicated with wound infection, 6.7% with seroma and 6.7% with wound dehiscence. The range of patient satisfaction was (5-10) while the mean patient satisfaction was 8.26. There were no significant difference between complicated and non complicated cases with regard to age, tumor size and number of cleared lymph nodes. There was a significant difference between complicated and non complicated cases regarding patient satisfaction.
Conclusion: The single incision approach in breast conserving surgery has a high success rate in its implementation, for lumpectomy.  Patients operated on using this procedure presented greater satisfaction with both the breast and with the informational process compared with standard surgery.

Analysis of Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: An Institutional Based Study

Shivendra Kumar Chaudhary, Pragya Sinha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2720-2726

Background: Among women, incidence rates for breast cancer significantly exceeded
those for other cancers in both transitioned and transitioning countries, it remaining as
a remaining as most commonly diagnosed cancer and the prominent cause of cancer
death in women worldwide. The present study was conducted to assess Clinico-radiopathological
Features and Biological Behavior of Breast Cancer in Young Indian
Women.
Materials and Methods: A prospective descriptive study was done among women aged
less than 40 years diagnosed with breast cancer. In patients with suspicious clinical or
ultrasound findings or if biopsy yielded malignancy, digital mammography was
performed. All the BI-RADS 4 and 5 lesions and few of the BI-RADS 3 lesions were
biopsied, and samples were sent for histopathology (HPE) and immunohistochemistry
(IHC) examinations. The data was collected on Microsoft Office Excel 2013 and
statistical analysis was performed using IBM SPSS version 21(Illinois, Chicago). P value
<0.05 was considered significant.

Triple Positive breast cancer: A case series

Vivek Gupta, Prerna Agarwal, Sunita Vagha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 600-607

Introduction: Breast cancer is the most common malignancy in women around the world,
accounting for 25.1 % of all cancers among women. Breast cancer are classified in different
molecular subtypes depending on hormone receptor positive or negative and human epidermal
growth factor receptor 2 status. All the three receptors labelled as ‘triple positive’ breast
cancer are rare entity. We herein describe a case series of three patients diagnosed as invasive
ductal carcinoma with Immunohistochemistry (IHC) positive for all three receptors (Hormone
receptors and human epidermal growth factor receptor).
Case presentation: Three patients aged 67, 40 and 34 years presented with breast lump and
were diagnosed invasive ductal carcinoma. There was no history of familial breast cancer, any
other malignancy, or hormonal medication.Modified radical mastectomy was done and
specimen sent to surgical pathology department for histopathology. Modified Bloom
Richardson’s score was 7 and 8 with histological grade 2 for two of the cases. IHC was
performed and was positive for Hormone receptor and human epidermal growth factor
receptor. All the three cases were labelled as ‘Triple Positive’.
Conclusion: Breast cancer with all three receptor positive are rare to find but these cases do
exist. The biological significance and cross talks of their related pathways should be
investigated further for ‘triple positive’ breast cancer to determine intrinsic as this would help
to view the treatment options if these patients receive endocrine treatment in combination with
HER2 blocking agents or a separate therapy.

“Breast cancer trends in a Tertiary Care Teaching Institute of South India”

Dr. M Bala Vikas Kumar; Dr. Venkat Rao Boinapally

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 313-318

Introduction: The Incidence of breast cancer has been found to increase gradually especially among younger women. This could be due to two reasons first is it may be reflecting the true incidence of the tendency of younger women to develop breast cancer or second could be due to increasing awareness and availability of modern screening methods which has led to the detection of cancers in early ages. Methods: We in this cross-sectional study screened n=125 women for breast cancer at RVM Institute of Medical Sciences, Mulugu, Telangana from January 2019 to Dec 2019. A total of n=120 cases were screened for breast cancer. Results: Out of n=125 women screened n=21 cases were detected with breast cancers.The incidence rate was calculated as 21%.Out of the total n=21 cases, n=7(33.33%) cases were found to malignant, n=14(66.67%) cases were benign lesions. Among the malignant lesions diagnosed the Invasive duct cell carcinoma was found in 71.43% of out of the total n = 7 cases of malignancy. In non-neoplastic lesions out of n=14 cases, fibroadenoma was diagnosed in 38.09% cases, followed by proliferative breast disease with atypia 14.28% and Phyllods in 9.52% cases. Conclusion: There is an urgent need for organized breast cancer screening programs especially in rural areas. A multidisciplinary approach is required to create awareness, screening, detection, and treatment. This can help reduce the incidence and mortality in cases of breast cancers.

Breast Screening Using 3D Automated Breast Ultrasound in Addition to Conventional B Mode Ultrasound

Amal Mahmoud Mohamed, Khalid Ahmed Lakouz, Ahmed Abd Al Azim, Mona Mohammed Refaat

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4404-4414

Background:Breast cancer is a major worldwide health problem. Many radiologists recognize
that there are increasing incidence of breast cancer in the past decade.Automated threedimensional
(3D) breast ultrasound (ABUS) was developed for better diagnosis of architectural
distortions.
Aim of work:evaluation of validity of ABUS in cancer breast detection in addition toHand Held
Ultrasound (HHUS).
Subjects and methods:This prospective cross-sectional study was done at radiology department of
Al Sheikh Zayed Aal Nahyan hospital and included105 female patients, aged >18 years old,
presented with breast complaint or screening, they were referred from general surgery
Department of Al Sheikh Zayed Aal Nahyan Hospital. They were evaluated by HHUS and ABUS
individually. Each lesion was assigned an independent BIRADS score for each
modality.diagnosis was confirmed by biopsy (56cases).
Results:HHUS and ABUS showed good substantial agreement regarding lesions classification
(benign or malignant) with kappa (κ) 0. 789.with diagnostic accuracy and sensitivity of ABUS
were higher than that of HHUS as for ABUS were 97.1% and 100% respectively, while for
HHUS were 90.5% and 90.7 % respectively.
Conclusion:From our results ABUS may serve as an effective new screening tool in addition to
HHUS.

A FRAME WORK TO DETECT BREAST CANCER USING KNN and SVM

RAJESH SATURI; K.V. Sai Phani; Prof.P. PREM CHAND

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1432-1438

The main reason of increasing mortality rate among women is the breast cancer. It makes several hours with the less availability of systems to identify the diagnosis of cancer manually. Hence there is a need to develop an automatic system for early detection of cancer. Several researchers have focused in order to improve performance and achieved to obtain satisfactory results. But unfortunately it will be very difficult to detect the cancer in beginning stages because the symptoms may be inappropriate.Therefore, there is a need to determine and acquire a new knowledge to prevent and minimizing the risk of getting effected with cancer. Machine learning (ML) is algorithms are widely used in detecting breast cancer patterns and predict the grading level. Machine learning techniques can be used to classify the stage of cancer, where machine can be trained from past data and build a model so that it can predict the category of new input.In this paper we used K-nearest neighbors (K-NN) and Support Vector Machine (SVM) on the dataset collected from UCI repository to detect breast cancerwith respect to the results of accuracy the efficiency of algorithm is also measured and compared.

SURGICAL MANAGEMENT OF BREAST CANCER PATIENTS USING LIGASURE™ SMALL JAW VERSUS MONOPOLAR ELECTROCAUTERY

Taha Abdelwahab Biomy, Mohammed Mahmoud Elkilany, Joseph Rizk Israel, Ali Sabry Ali Helal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4614-4619

Background: Electrocautery  is commonly used for various surgical procedures such as mastectomy is used to stop bleeding and perform dissection. It has been suggested that thermal  spread can cause flap necrosis, wound infection, prolonged drainage, and damage to the surrounding tissues. Several studies have reported that the LigaSure Small Jaw device can reduce the incidence of seroma. The present study aimed to evlaute the effectiveness of monopolar electrocautery  compare to  LigaSure™ Small Jaw in reducing the postoperative seroma in patients  with breast cancer  who undergoing radical mastectomy. Patients and methods:  this study included 40 females with breast cancer who attending for modified radical mastectomy. The patients were divided equally into the monopolar electrocautery group and the LigaSure™ Small Jaw group. Results: There was statistically significant difference between groups as regard duration surgery. Also, amount of blood loss was statistically larger among Electrocautery group than LigaSure™ Small Jaw group.As regard Post-operative complications ,seroma was the commonest complication followed by flap necrosis and wound sepsis respectively, with no difference between both groups. There was statistically significant difference between different VAS readings at different timings between studied 2 groups. Conclusion: LigaSure™ Small Jaw was more effective than Electrocautery in reducing the intraoperative and postoperative complication in breast cancer patients undergoing modified radical mastectomy.
 

Association of CYP3A4 and CYP3A5 Polymorphisms with Indian Breast Cancer Patients& Its Clinical Implications

Venkataramana Inagaluri, Prasad Rao K.V.S., Natukula Kirmani

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2829-2835

Introduction:  Polymorphisms of the different genes have been reported to be associated with a variety of cancers including breast cancer. CYP genes belongings to Cytochrome P450 (CYP450), have been implicated in various cancer formation and development due to their roles such as oxidative stress, activating procarcinogens, and inactivating anticancer drugs.
Objective: This study aimed to examine whether polymorphisms in the CYP3A4 and CYP3A5 genes affect the risk of developing breast cancer.
Results: CYP3A4*1B gene polymorphism revealed that in breast cancer patient group 96 had the *1A/*1A genotype  (64%), 39 (26%) had the *1A/*B genotype and 15 (10%) had the *1B/*B genotype. In the control group 131 (87%) had the *1A/*1A genotype, 16 (10.66%) had the *1A/*B genotype and 3 (2%) had the *1B/*B genotype. Concerning genotype distribution, a significant difference between the breast cancer patients and the controls was observed where p<0.05) The genotype frequency of the CYP3A5*3 *1/*1, *1/*3, and *3/*3 polymorphisms in breast cancer and healthy control group were analysed. Frequencies of CYP3A4*3 *1/*1, *1/*3 and *3/*3 genotypes were 67.3%, 24% and 8.7 % in breast cancer patients and 79.3%, 14% and 6.7% in the controls, respectively. The distribution of CYP3A5*3 *1/*3 genotypes was significantly associated with breast cancer patients when compared with controls.
Conclusion: In conclusion, the results of our study found a positive association between CYP 3A4*1B and CYP3A5*3 polymorphisms and predispositions to breast cancer risk.
 

Early Diagnosis of Breast Cancer by Detection of Genetic Variation for BRCA1 and BRCA2 Genes in the Women's of Nineveh Province

Nada Saad Omer; Dr.FİLİZ SARIKAYA PEKACAR; Dr. HananShihab Ahmad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1525-1532

Women's Breast Cancer ranks first among other type in Iraq and the world. It often detects because of
examinations performed in patients on familial cancer history. Approximately, 10% of hereditary breast cancer
represents of all breast cancer cases and BRCA1/2 represented the responsible genes. Mutations in the BRCA1/2
germ increases the risk of hereditary breast cancer twenty times more. Therefore, the detection of BRCA1/2
genes mutations is important for the diagnosis, treatment and application of clinical methods of patients. New
generation sequencing is more useful than classical methods. With this method, a patient-specific clinical
treatment can be customized, treatment, and early diagnosis, facilitates new discoveries, identification of existing
mutations, primarily breast and ovarian cancer.
In this study, the female patients had selected between the ages of 18-49 living in Nineveh-Iraq and having
demographic identical qualities, the samples taken within the consent of the participants were examined and
some significant mutations had been detected. Bioinformatics studies of variants evaluatedas pathogenic were
performed. In addition, variants of unknown clinical significance were identified and listed.Based on the results
obtained in the study, it is concluded that tests should be applied directly in the laboratory environment to
develop an understanding based on the Next Generation Sequencing approach for the detection of BRCA1 and
BRCA2 mutations and to evaluate the functional role of the mutations. In addition, our study draws a conclusion
for the early diagnosis of the New Generation Sequencing technique and the development of a personalized,
patient-specific treatment approach.

The Effect of Arm Exercises on The Prevention of Lymphedema in Post- Mastectomy Breast Cancer Patients at Haji Adam Malik Medan Hospital

Helinida Saragih; Nurmaini .; Ikhsanuddin Ahmad Harahap

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2025-2028

Breast cancer is a malignant neoplasm, an abnormal growth of breast tissue that does not see the surrounding tissue, grows infiltrative and destructive, and can metastasize. Every breast cancer patient experiences side effects from various treatment treatments. This is because the therapy that each patient gets varies and also that cancer sufferers have different genetic backgrounds and different environments. Mastectomy in breast cancer patients can cause many patients to suffer from decreased joint mobility, lymphedema, and limitation in daily activities. These complaints can be overcome with arm exercises. Arm exercises are done to improve circulation and muscle strength and to prevent joint stiffness, preventing lymphedema from occurring. The purpose of this study was to analyze the effect of arm exercises on lymphedema prevention by looking at the value of arm measurements before the intervention and after intervention in the intervention and control groups. The research design was a quasi-experimental study with a total sample size of 32 respondents per group so that the total sample was 64 respondents. The research results were based on the t-test. The independently obtained p=0.001, namely p <0.005, which means that there was a significant effect of the arm measurement value on post-mastectomy breast cancer. It is hoped that this study can be used as education for post-mastectomy patients to improve the lymph flow so that lymph flow obstruction does not occur.

A Tertiary Medical College Hospital based Observational study to evaluate the correlation between antithyroid peroxidase antibody levels in patients with invasive breast cancer

Senthilkumar A. C.; Sridharan. S

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1647-1651

Background: Very few studies have assessed prevalence of anti-thyroid peroxidase antibodies in women with breast cancer. In this study, we aimed to assess the prevalence of anti-thyroid peroxidase antibodies in women with breast cancer.
Methods: Tertiary hospital based cross - sectional study carried out at Saveetha Medical College, Chennai, during the period of August 2018 to July 2020. Seventy-five women in surgical oncology ward/OPD were included in the study. Subjects included in the study were between age 35 to 80 years, provided they fulfilled inclusion and exclusion criteria. History was noted, serum anti-thyroid peroxidase antibodies test was done. Results were noted and analyzed.
Results: Out of 75 subjects, 21.3% of women with breast cancer were having elevated anti-thyroid peroxidase antibodies.
Conclusions: Prevalence of anti-thyroid peroxidase antibodies is high among women with breast cancer. These results have implications both for screening of patients for thyroid disorders and also for development of new prognostic markers. Therefore, routine screening is preferable among women with breast cancer.

DETECTION OF MICROCALCIFICATION CLUSTERS USING STATISTICAL PARAMETERS AND DYADIC CONTOURLET TRANSFORM BASED PRECISION ENHANCEMENT

Venmathi A R; A. Senthil Kuma; M. Gomati; G. Suresh

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 2423-2436

—Recent scenario, breast cancer found to be a threat and dangerous carcinoma among women in the world. In contemplation of reducing the breast, cancer-related death needs an efficient computer-aided diagnosis (CAD) system. The discrimination of microcalcification clusters (MCCs) is an important manifestation for the early diagnosis of breast cancer. This paper focuses on the detection of breast cancers cells size below 2mm. To achieve précised enhanced cancer cell region an efficient technique dyadic Counterlet transform (DCTs) in two dimension is proposed. The enhancement of cancer cell region obtained through preserving the boundaries and borders with curvature for a small region.

DETECTION OF MICROCALCIFICATION CLUSTERS USING STATISTICAL PARAMETERS AND DYADIC CONTOURLET TRANSFORM BASED PRECISION ENHANCEMENT

Venmathi A R; A. Senthil Kumar; M. Gomati; G. Suresh

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 2423-2436

Recent scenario, breast cancer found to be a threat and dangerous carcinoma among women in the world. In contemplation of reducing the breast, cancer-related death needs an efficient computer-aided diagnosis (CAD) system. The discrimination of microcalcification clusters (MCCs) is an important manifestation for the early diagnosis of breast cancer. This paper focuses on the detection of breast cancers cells size below 2mm. To achieve précised enhanced cancer cell region an efficient technique dyadic Counterlet transform (DCTs) in two dimension is proposed. The enhancement of cancer cell region obtained through preserving the boundaries and borders with curvature for a small region.

Ki-67 and It’s Correlation Between The Clinical And Histological Parameters In Breast Cancer Patients - An Institutional Study

Dr Siddharth Mahender; Dr Bharathi Raja.K; Dr Akshaya Gunasekar; Prof. Dr.K.S Ravishankar.K.S

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2854-2864

Breast cancer is a major health issue and yet there lacks studies which show the correlation between Ki-67 as a prognostic marker and the variables of breast cancer.
Aim: to correlate Ki-67 index with clinical and histological parameters of breast cancer. Methods and materials: it is a cross-sectional study done on 86 cases of cancer breast who presented to the institute SBMCH, Chennai in one and a half years duration. Age, tumor size, site , menopausal status, lymph node involvement ,histological type and grade, Ki-67 index were determined and correlated in these patients.Results: the mean age was 52 years, and most of them (62.8%) were post-menopausal. The tumors were more common on the left breast compared to right. Size of 2-5cm were more prevalent and more cases had nodal involvement in our study. Out of the histological types Invasive ductal was most common followed by Papillary carcinoma and Invasive lobular carcinoma. In our study Ki-67 did not show any significant correlation with the age(p=0.427), gender(p=0.447),side of the tumor(p=0.619), menopausal status(p=0.121), pathological size of the tumor(p=0.169),nodal involvement(p=0.568) or histological type of the tumor(p=0.373). However a really significant correlation was observed between grade of the tumor(p<0.001). Concluding that in our study there was a significant correlation between ki-67 and tumor grade which is an established prognostic marker, and hence it plays a vital role in deciding the prognosis of breast cancer.

In-Vitro evaluation of anti-cancer and genotoxic potential of medicinal herb Saussurea lappa extract in human cancer cell lines

Ayyub A. Patel; Mohammed Amanullah; Fahmy G. Elsaid; Tamer Soliman; Mohamed Eissa; Hani Alothaid

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 736-747

For centuries, plants are known to play part in the daily routine from providing food to the management of human health. During the last few decades, diverse phytochemicals have been characterized as agents that possess a potential to execute cancer cells. The oil extracted from the root of Saussurea costus; has been used in traditional medicine for a long time. Purpose: This study was carried out to assess the effect of Saussurea lappa aqueous extract on five different cell lines; Human Lung Fibroblast cells (MRC5), Human Dermal Fibroblast adult (HDFa), Madin-Darby Canine Kidney cells (MDCK), breast cancer cells (MCF7) and human colonic cancer (Caco2). Results: On normal cell lines; the extract showed cytotoxic activities with the half maximal inhibitory concentration; IC50 values, ranging from 0.85 to 2.5 mg/ml whereas MRC5 was the most sensitive cell line (IC50 values: 0.85). On malignant cell lines; MCF7 cells showed inhibition in cell proliferation with activity from 67.17% to 91.01% by the extract treatment concentration 0.50 to 2.0 mg/dl. However, Caco2 cells exhibited inhibition in proliferation ranging from 37.10% to 69.45% by the same treatment dose. Thus, breast cancer cells were more sensitive than colon cancer cells to Saussurea costus extract. The genotoxic potentialities of the crude extract showed increase in expression of proapoptotic genes; P53, IκBα, BAX and TNF and decrease in the expression of antiapoptotic genes; Bcl2, Survivin, and MMP-7. Conclusion: Our work pointed out that Saussurea lappa extract could be a potential candidate that has the capability to fight cancer.

A MODE FUZZY WEIGHT BASED CANONICAL POLYADIC (MFWCP) AND ADAPTIVE NEURO FUZZY INTERFACE SYSTEM (ANFIS) FOR MISSING VALUE IMPUTATION IN BREAST CANCER PREDICTION

S.R. Lavanya; Dr.R. Mallika

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 2053-2066

Most of the women are affected by BC (Breast Cancer) which is one of the dreadful diseases in the entire world and considered as subsequent threatening reason of cancer death in women. The likelihood of death can be significantly reduced by means of early detection and prevention. Hybrid Bayesian frameworks were utilized previously for breast cancer prediction and handling missing values in patient’s characterization. WCP (Weight Canonical Polyadic) algorithms manage continuous missing values in the data by using least squares recursively. A main bottleneck in using WCP is the unfolding of multiple relationships of discovered modes (N). The complexity increases when the value of N is large. This paper uses imputations in attribute dependencies for enhancing BC detections. This work divides the dataset into discrete and continuous subsets where discrete fields are assigned values using BN (Bayesian Networks) followed by Tensor factorization on an integrated dataset using MFWCP (Mode Fuzzy Weight based Canonical Polyadic). The new dataset is created from full/missing value subsets for assigning values to fields with missing values. MFWCP operations result in operations where N value of WCP is greater than three. This third order is reduced to first order WCP by applying Khatri-Rao product. DT (Decision Trees), KNN (K-Nearest Neighbors) and ANFIS (Adaptive Neuro Fuzzy Inference System) classifiers are combined to classify BC and the proposed hybrid method is evaluated using defined performance measures enhanced imputation accuracy.

The Effect of TNFα -308G/A Gene Polymorphism with Breast Cancer Risk in Iraqi Population

Anwar Abed Nasser Dhabaan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 163-167

The study included two hundred and thirty samples of which 130 patients women of
breast cancer in Iraqi population,, their ages ranged from 29 to 71 year (ages mean 42.95
± 1.5) and 100 controls (healthy women), their ages ranged from 25 to 65 year (ages
mean 31.37 ± 1.9). We confined the frequency of TNF-α gene -308G/A polymorphism by
TARMS PCR technique (Tetra-amplification refractory mutation system-polymerase chain
reaction technique). Also, we determined the association of TNF-α gene -308G/A
polymorphism with breast cancer of Iraqi women population. Statistical results showed
significant difference in genotype frequency of TNF-α gene -308G/A polymorphism with
breast cancer women patients and control (healthy women). The A allele showed high
frequency in breast cancer patients comparison with control (healthy women) and present
with etiological fraction risk (EF) of breast cancer patients in Iraqi women, and its ratio
64.23% in patients while in control 50.50%. The G allele shows high frequency in control
comparison with breast cancer patients was 35.77% and 49.50% respectively, and
present related with protective fraction (PF) with breast cancer patients was (0,21.4). The
genotypes of AA and GG (homozygotes) shows high frequency in breast cancer patients
was 58.46% and 30% respectively, comparison with control was 16% and 15%
respectively, also AA and GG homozygotes genotypes showed relationship with
etiological fraction risk of breast cancer in women patients, while the GA heterozygote
genotype show high frequency in control (healthy) was 69% comparison with breast
cancer patients was 11.54%, and show related with preventive fraction of breast cancer
patients. Our findings demonstrate that the TNFα -308G/A gene polymorphism may
represent a risk factor for breast cancer development of patient’s women in Iraqi
population.

Comparative Analysis Of Rt-Pcr And Immunohistochemistry Methods For Determining Her2 Status In Breast Cancer Samples

Shokhista Rustamova; Yodgormirza Nurmatov; Muazzam Bakiyeva; Tokhirjon Rakhmanov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 3924-3929

This study aimed to compare two methods of quantitative polymerase chain reaction (qPCR) using the intercalating SYBR Green dye and TaqMan hybridization probes to determine the amount of the HER2 gene (human epidermal receptor) in breast tumours.
Methods--- The experiments were carried out with 32 validated samples of breast cancer and two gastric cancer cell lines. An immunohistochemical (IHC) assay was used to evaluate the accuracy of the RT-PCR methods.
Results--- The obtained results show that real-time PCR with the TaqMan probes allows the use of a small amount of DNA (≥0.4 ng/μl) to determine the overexpression of the HER2 gene. Real-time PCR with SYBR Green allowed us to determine the minimum number of false negatives resulting from the absence of marker expression in tumour tissue.
Conclusions--- The full correspondence of the results of the RTPCR and immunohistochemistry methods obtained for the cell line samples makes it possible to introduce the qPCR method into clinical practice for use in detecting the HER2/neu gene content.

Discovery of Aminoglycoside Derivatives as a Potent Inhibitor for the Prognostic P4HA1 gene in Breast Cancer: A Holistic Genomic and Virtual Screening Approach.

Manikandan Murugesan; Premkumar Kumpati

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 920-941

Prolyl 4-Hydroxylase Subunit Alpha 1 (P4HA1) is a catalytic enzyme that involves synthesis of collagen and extracellular matrix interactions. Aberrant expression of P4HA1 promotes carcinogenetic invasion and metastasis in breast cancer. In this study, we combined transcriptomic and drug repositioning approach for the intervention of new targeted anti-cancer therapy for breast cancer. The mRNA expression, copy number variation, mutation and clinical patient’s outcome of P4HA1 validated through cBioportal. High-throughput virtual screening and MM-GBSA analysis were performed with Drugbank approved molecules (9,612) for identifying the potent therapeutic drug molecules against P4HA1 using Schrodinger. The cBioportal based gene expression of P4HA1 in the TCGA-breast cancer cohort revealed significant elevated expression in the breast tumor compared to the normal. Subsequently, the high copy number amplification and mRNA expression was high in the invasive breast carcinoma compared to the other subtypes. In addition, the overall survival was validated with median P4HA1 expression and conferred with poor prognosis of breast cancer patients. Further, receptor based virtual screening identified top hits of aminoglycoside derivatives, amikacin (glide score −9.58 kcal/mol) and gentamicin (glide score −7.02 kcal/mol) with best docking score and stable interaction with favorable amino acid residues of P4HA1 includes Glu171, Asp178, Lys213, Lys 206 and Leu174. Moreover, both the drug passed the drug-likeness property (ADME) and MM-GBSA energy model. This study integrates genomic and molecular docking approach, suggests P4HA1 as a prognostic biomarker and selective inhibition might be therapeutically involved in the breast cancer intervention.

DNA based CGB methylation in breast cancer a case control study

Dr. Anjana Vasudevan; Dr. Vasugi. G. A.; Dr. R. Ponniah Iyyappan; Dr. Harpreet Kaur; Dr. Balaji Singh; Dr. Guru Prasad; Dr. C. S. Subramanium; Dr. C. Kaliyappa

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 55-61

Breast carcinoma is the most commonly diagnosed cancer and the leading cause of cancer death. Breast cancer also produces and is influenced by ectopic hormones. Beta Human Chorionic Gonadotropin (hCG) is one such hormone and is encoded by chorionic gonadotropin beta (CGB) genes. The aim of this study was to determine the CGB gene methylation in breast cancer tissues and compare them with normal tissues.
Materials and methods: After approval from Institutional Ethical Committee (IEC), consent from patients were obtained. Normal and tumour tissues from breast cancer patients were taken. DNA was isolated from normal and tumour tissues. Post bisulfate conversion samples were processed for qPCR using methylation specific primers for the set of selected CGB genes and SYBR green.
Results: 1-2M was found to be significantly higher among the normal tissues (50.22). 3-9M was found to be 65.93 in tumour tissues and 5.05 in normal tissues and this was significant.
Conclusion: 3-9 M is significantly higher in tumour tissues compared to normal tissues and 1-2 M is significantly higher in normal tissues. This suggests that there are 2 different types of beta hCG secreted by two different types of genes and this can be used for further analysis as a part of future projects. This may help in formulating a new treatment process and may also be used as a tumour marker in high risk patients

Molecular Detection of Mouse Mammary Tumor-like Virus (MMTV-Like) in Breast Carcinoma for Iraqi Female Patients

Hasan A. Mohammed; Müge Fırat; Mohammed E. Mansur

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1533-1566

Background: The mouse mammary tumor virus (MMTV)-like env gene have
previously been reported to be present in some human breast cancers, however, their
role in developing that cancers is still unclear.
Aim: This study aims to investigate the presence of MMTV-like env gene among
Iraqi women who have breast cancers.
Methods: The prevalence of MMTV-like env gene and beta-globulin gene in
formalin-fixed paraffin-embedded (FFPE) breast tissue specimens of 88 Iraqi women
with breast cancers was detected using conventional PCR and Real- Time techniques.
Eight benign breast tumors’ specimens were also used as controls. Fisher’s exact test
was used to analyse data.
Results: MMTV-like env gene were detected in 16 (18.8%) specimens of those with
breast malignancies, while they were not identified in benign breast tumors
specimens. However, no significant difference between two groups was noted.
Conclusion: MMTV-like env and beta-globin genes were detected in Iraqi women
with breast cancer, and further research is needed to study the role and association of
these env gene with cancer development.

A REVIEW OF MACHINE LEARNING FRAMEWORKS FOR EARLY AND ACCURATE PREDICTION OF NEOADJUVANT CHEMOTHERAPY RESPONSES

Uddaraju Susmitha; Narasingarao, M. R

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 4, Pages 1040-1050

The ability to predict the reaction of breast tumors to neoadjuvant chemotherapy from the get-go over the span of treatment can delineate patient’s dependent on the reaction for explicit tolerant treatment procedures. From now on, reaction to neoadjuvant chemotherapy is measured as being based on physical examination or breast imaging (mammogram, mri, or normal MRI). There is a powerless connection with these projections and with the actual tumor size as measured by the pathologist through authoritative procedure. Given the numerous options open to Neoadjuvant chemotherapy (NAC), it is important to develop a plan to predict response over the care period. Sadly, as long as certain people are not seen as responding, their condition can never again be specifically resectable, so this situation should be preserved at a strategic remove from progressing response appraisal protocols throughout the care regimen. This paper provides a review of all the existing frameworks of machine learning involved to perform accurately neoadjuvant chemotherapy responses

Early Diagnosis of Breast Cancer by Detection of Genetic Variation for BRCA1 and BRCA2 Genes in the Women's of Nineveh Province

Nada Saad Omer; Dr.FİLİZ SARIKAYA PEKACAR; Dr. HananShihab Ahmad

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4443-4456

Women's Breast Cancer ranks first among other type in Iraq and the world. It often detects because of examinations performed in patients on familial cancer history. Approximately, 10% of hereditary breast cancer represents of all breast cancer cases and BRCA1/2 represented the responsible genes. Mutations in the BRCA1/2 germ increases the risk of hereditary breast cancer twenty times more. Therefore, the detection of BRCA1/2 genes mutations is important for the diagnosis, treatment and application of clinical methods of patients. New generation sequencing is more useful than classical methods. With this method, a patient-specific clinical treatment can be customized, treatment, and early diagnosis, facilitates new discoveries, identification of existing mutations, primarily breast and ovarian cancer.
In this study, the female patients had selected between the ages of 18-49 living in Nineveh-Iraq and having demographic identical qualities, the samples taken within the consent of the participants were examined and some significant mutations had been detected. Bioinformatics studies of variants evaluatedas pathogenic were performed. In addition, variants of unknown clinical significance were identified and listed.Based on the results obtained in the study, it is concluded that tests should be applied directly in the laboratory environment to develop an understanding based on the Next Generation Sequencing approach for the detection of BRCA1 and BRCA2 mutations and to evaluate the functional role of the mutations. In addition, our study draws a conclusion for the early diagnosis of the New Generation Sequencing technique and the development of a personalized, patient-specific treatment approach. 

Sleep Quality, Fatigue And Medication Adherence Among Breast Cancer Survivors At Chennai - A Descriptive Study.

Dr.Shankar Shanmugam Rajendran; Dr. Pradeep Kumar Naik; Mr.Kannan Kasinathan; Mr. Anbalagan Murudan; Mrs.Rizwana Ibrahim; Mrs.Nirmala Asaithambi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1424-1439

The cancer survival journey starts for the person at the time of diagnosis and lasts until the end of life, with adverse effects on normal activities. Breast cancer mortality is strongly associated with poor sleep. Fatigation and decreased appetite are the hallmarks of cachexia in terminally ill patients. Inadequate medication adherence may cause alterations in risk-benefit ratios. Aim: To assess the sleep quality , fatigue, and medication adherence among breast cancer survivors and to find their association with the selected demographic variables. Methods: This was a descriptive cross-sectional analysis involving 60 samples of OPD medical oncology using a convenient sampling technique and the study duration was one week. Pittsburgh sleep quality index scale, Perform questionnaire, Medication adherence rating scale were used to assess the patients. RESULTS: The study concluded that 61.67% of the cancer survivors were disordered sleepers, 45.00% of the cancer survivors were having low fatigue score and 71.67% of the breast cancer survivors were having good medication adherence score. There was a strong positive equal correlation between the Sleep Quality Index score and the Fatigue score, which indicates that the quality of sleep raises the fatigue score. CONCLUSION: Clients suffering with breast cancer should be assessed for sleep quality, which directly helps to reduce the fatigue level. Evidence-based practice interventions like Exercises, cognitive behavior therapy, yoga, and aerobic exercises could help the patient to have adequate sleep.

Loss Of Immunohistochemical Expression Of Pten As A Predictive Biomarker In Breast Carcinoma

Iftikhar Altemimi; Binan Adil Alaaragy; Yassir Alaa Shubbar; Rihab Hameed; Salah Jumaah

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 3653-3668

Background: Breast cancer is the most common malignancy with a high mortality in females worldwide. Tumor suppressor genes had significant role to maintain genome integrity and the cell cycle. In particular PTEN is a candidate tumor suppressor gene, It has a negative regulator of PI3K/AKT signaling pathway which has a major role in carcinogenesis and dysregulation of it occurs repeatedly in breast cancer. Aim: this article aimed to appraise the associations between PTEN expression in patient had breast cancer with clinic pathological parameters including: age, histological types, and status of estrogen receptor, progesterone receptor, and HER-2/nue receptor, to check the impact of its expression on clinical outcome. Materials and methods: in this case-control study, formalin fixed paraffin embedded tissue from sixty patients with breast carcinoma and twenty patients without cancer (as control groups). Labeled Streptavidin -Biotin (LSAB+) method used to detect PTEN protein expression, HER2/neu, ER and PR receptors by immunohistochemical assay, and then we correlate PTEN expression with each biomarkers and clinic pathological characteristics. Results: 29/60 (45.3%) of cases decreased PTEN expression while its expression retained in 31/60 (51%) of cases. Loss of expression significantly associated: with lymph node metastasis ( p-value=0.0008 ), high grade (p< 0.05 ) , high stage (p-value=0.0001 ) and with triple negative breast cancer (p-value=0.03) . However, loss of PTEN protein expression did not correlate with age, histological types, estrogen, progesterone and HER-2 receptors status. Conclusion: PTEN loss can predict aggressive behavior and worse outcome in patients had breast cancer.

Increased expression of oxidative phosphorylation genes in breast cancer cells

Jolanta Rzymowska; Ludmi&;a Grzybowska-Szatkowska; Ludmi&;a Grzybowska-Szatkowska; Ludmi&;a Grzybowska-Szatkowska; Brygida Slaska; Izabella Cisek; Katarzyna Wach; Sebastian Mazur; Paulina Stachyra; Ludmi&;a Grzybowska-Szatkowska

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 14-19

Aim: The aim of this study was to analyse the expression at the mRNA level of cytochromeb, subunits COI, COII, COIII of complex IV, ATP6 and ATP8 and to perform aquantitative analysis of the activity of ATP synthase as complex V of the respiratory chain, responsible for ATP synthesis and break down of ATP to ADP in breast cancer. Methods and Results: The level of gene expression at the mRNA level was evaluated on the basis of the light intensity of fluorochrome or fluorescein in the cells. Determination of the activity and location of the ATP synthase in cells was carried out using hybridization. In the formulations of breast cancer there was a higher genes expression at the mRNA level for all the examined genes as compared with non-cancerous tissue. The ATP activity was also higher in preparations obtained from breast cancer cells compared with the control tissue. Conclusions: The results confirm mtDNA incorporation to nDNA in neoplastic cells. They point to increased expression at mRNA level for COI, COII, COIII, ATP6 and ATP8 in breast cancer cells compared with control tissue. Increased amount of ATP synthase points to increased ATP in a neoplastic cell.